Treating Drug Abuse to Reunite Families

Drug abuse is a common problem in child neglect cases. An Arizona program treats parents who risk losing their kids.

Two years ago, Rob Guy couldn’t take his brand-new baby girl home from the hospital. His drug use had become a barrier between him and his newborn. “Child Protective Services (CPS) showed up on the sixth day and refused to let us [leave with her],” Guy recalls.

Although Guy had been in and out of rehab for more than 20 years, it was not his drug use that separated him from his little girl that day. The baby’s mother also used drugs, including during the third trimester of her pregnancy, which got the attention of CPS. When the mother and child were ready to go home, CPS stood in the doorway.

This was not the day Guy and his girlfriend lost their child, however. This was the day they were introduced to Arizona Families FIRST (Families in Recovery Succeeding Together). Instead of taking away the little girl, CPS sent the family home together.

Often, drug use and Child Protective Services are uttered in the same breath. But Families FIRST seeks to change that dynamic. The program, which was created with $10 million in federal welfare funds in 2000, focuses on treating adults for substance abuse in an effort to rehabilitate families and reunite children and parents.

The program is free, regardless of income, and designed to begin within days of a child’s removal from the home. Policy dictates that outreach occur within 24 hours and an assessment for treatment within five days of a parent agreeing to get help.

For Guy’s family, his girlfriend had to agree to undergo treatment, and in order for all of them to go home together that day, they also had to agree to let a “safety monitor” accompany them home with their newborn child. Since Guy had his own issues with substance abuse, his girlfriend’s ex-husband was put in charge of making sure the home environment was safe for the baby.

The goal of the program is permanent reunification of children and their families. Within the past year, about one-quarter of children involved in Families FIRST left foster care to return home. But one of the biggest challenges is getting parents to accept treatment in the first place. About half of those referred don’t enter treatment, and of those who do, less than 40 percent successfully completed a Families FIRST treatment program last year.

Guy wanted his little girl back, so he signed paternity documents rather than submitting to a paternity test, accepted full responsibility for the child and entered treatment. “I wasted a lot of my life in drug use. It was time for me to step up and be a father,” Guy says.

Guy was clean when he entered treatment, so he received relapse prevention treatment instead, followed by after care. Part of his treatment involved regular drug testing, a policy integral to assessing the effectiveness of treatment and holding clients accountable. The average length of treatment is 90 days and costs taxpayers an average of $3,000.

In addition to prescriptions, psychological evaluations and counseling, parents can receive child-care, housing and utility assistance, and case management. “[The program] provides transportation, if necessary, child care, uniforms for a job -- anything that will help them,” says Cathy Hasenberg, a substance abuse specialist with the state Division of Children, Youth and Families.

Since its start in 2000, Families FIRST has successfully treated thousands of parents. In that same period, states in general have begun to see the importance of salvaging the family and home life. Agencies across the country are offering more parenting classes and substance abuse treatment services than ever before, according to a 2009 study by the U.S. Department of Health and Human Services (HHS). And Families FIRST is recognized as a model program. It was cited by HHS as a best practice in its 2010 study. “I find when I talk to people in other states that our program is quite progressive regarding best practices,” Hasenberg adds.

And this was all before the recession. Hasenberg says that a smaller budget and new, restricted qualifications for federal funding has left the program operating on a skeleton budget. In June, Families FIRST stopped offering treatment to parents not at risk of having their kids removed. Previously, CPS would refer people they believed could benefit from treatment, even if the children weren’t in immediate danger.

While funding falls, the number of clients is on the rise. According to a 2011 program report, Families FIRST saw an increase of 15 percent in referred clients since 2010, and even more referrals are now accepting treatment. This leaves an ever widening gap between funding and services.

Right now, Families FIRST is relying heavily on alternative sources of aid. Some clients that have become Medicaid ineligible may receive federal money through the Substance Abuse Prevention and Treatment block grant, which helps priority groups such as pregnant users, mothers and intravenous users. And the program is trying to be “more efficient because that will reduce costs,” Hasenberg says.

It has been two years since Guy and his family were introduced to Families FIRST. Today he is clean, and his daughter is a thriving toddler. Guy, who is also a veteran, now works as a recovery coach at the very treatment facility he got help from. He’s found purpose helping others break free from substance abuse and creating new programs to help veterans dealing with post-traumatic stress disorder.

“My firm belief is that you’ve got to get out what’s inside or you’re never going to be free from it,” he says.

Gov. Gavin Newsom and Mayor Bill de Blasio initiated ambitious plans this week to cover drastically more residents, including undocumented immigrants who are not currently eligible for subsidized insurance.